Shift work sleep disorder is a circadian rhythm sleep disorder that is caused by working irregular or nontraditional hours, such as nighttime shifts or alternating shifts.
Many professions, particularly in the public health and safety domains, require 24-hour operations. Therefore, the workday is divided into multiple shifts, which are covered by different groups of employees.
It is estimated that approximately 20% of working adults work irregular shifts outside the typical 9:00 a.m. to 5 p.m. workday. However, shift work can be difficult to cope with and have several negative consequences, including shift work disorder.
This article discusses the symptoms, causes, diagnosis, and impact of shift work sleep disorder, as well as some coping strategies that may be helpful for shift workers.
Causes of Shift Work Sleep Disorder
Regularly working nighttime shifts or irregular shifts conflicts with your body’s natural sleep-wake cycle, or circadian rhythm, which can impact your ability to sleep and stay awake, resulting in shift work sleep disorder.
The human body has a 24-hour cycle of bodily processes known as a circadian rhythm that is attuned to the light of the sun. The circadian rhythm governs many internal functions, including sleep, digestion, body temperature, blood pressure, heart rate, and hormone production, among other things.
We are essentially biologically programmed to sleep during the night and be productive during the day. Working night shifts or a mix of day shifts and night shifts interferes with your body’s circadian rhythm because it requires you to be awake when you’re supposed to be asleep and vice versa.
These are some factors that can contribute to the development of shift work sleep disorder, or exacerbate it:
- Having a stressful job
- Working busy night shifts
- Eating meals at irregular times
- Having a long work week (over 40 hours of work per week)
- Not getting a day off to rest after a night shift
- Not being able to rest or take breaks during night shifts
- Having considerable home, family, or other responsibilities outside of work that make it difficult to sleep during the day
- Not having a strong support system or work-life balance
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Symptoms of Shift Work Sleep Disorder
These are some of the symptoms of shift work sleep disorder:
- Poor sleep quality
- Difficulty falling asleep
- Nightmares and other sleep disturbances
- Excessive daytime sleepiness
- Chronic fatigue
- Irritability
- Decreased alertness
- Trouble concentrating
- Impaired memory
- Higher levels of stress and distress
- Difficulty functioning and performing daily activities
A 2017 study notes that symptoms such as difficulty falling asleep and feeling extremely sleepy during the day can persist for several days after your last night shift, even after your sleep cycle has been returned to more traditional timings.
Impact of Shift Work
Shift work can take a toll on your mental and physical health.
Impact on Your Physical Health
Working irregular hours and not getting enough sleep can raise your risk of physical health conditions such as:
- Stroke
- Heart disease
- Cancer
- Obesity
- Diabetes
- Infertility
- Digestive issues
- Hormonal imbalances
- Pregnancy complications
- Infectious diseases
Impact on Your Mental Health
Shift work can also affect your mental health and raise your risk of conditions such as:
- Depression
- Anxiety
- Alcohol and substance use
- Stress-related conditions
Other Drawbacks of Shift Work
Apart from health consequences, shift work also has other risks and drawbacks, such as:
- Increased risk of workplace errors and accidents
- Higher risk of car accidents caused by falling asleep at the wheel
- Less efficient work performance
- Lower levels of job satisfaction
- High levels of absenteeism from work
- Higher healthcare costs
- Poorer overall quality of life
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Diagnosing Shift Work Sleep Disorder
If you think you might have shift work sleep disorder, it may be helpful to see a sleep specialist. Your primary healthcare provider can provide a referral to one, if you need it.
The sleep specialist will interview and ask you about your medical history, sleeping habits, work shifts, and the symptoms you’re experiencing.
They may also recommend that you undergo a sleep study that can measure various bodily functions while you sleep.
Coping With Shift Work Sleep Disorder
These are some strategies that can help you cope with shift work sleep disorder:
- Prioritize sleep: It’s important to prioritize sleep when you’re off-duty, to ensure you’re getting enough rest.
- Regulate light exposure: Keep bright lights on while you’re on the night shift, to help you stay awake. When you get home, close the curtains and switch off the lights, so the room is dark enough for you to sleep.
- Solicit family members’ cooperation: Ask family members not to disturb you while you sleep during the day. Request them to use headphones while listening to music, watching movies, or taking calls.
- Don’t drive if you’re too tired: If you’re too tired to drive, make alternate arrangements. Call a cab, take public transportation, get a ride from a coworker, or ask a loved one to pick you up.
- Plan naps: Try to plan night shifts such that you can take a nap in between. If your workplace allows it, try to rotate nap breaks with your coworkers over the course of the night shift.
- Avoid rotating shifts: Consistently working either a day shift or night shift is better than working rotating shifts, as rotating shifts doesn’t give your body a chance to settle into a daily rhythm.
- Use a sleep aid: If you’re having difficulty falling asleep when you’re supposed to, check with your healthcare provider if a sleep aid such as melatonin is right for you.
- Maintain a healthy routine: Working shifts can make it hard for you to exercise and eat healthy meals. However, it’s important to follow a healthy routine and diet to maintain your immunity.
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Shift work can be difficult to cope with. It can make it hard for you to get enough rest and affect your mental and physical health. It can also jeopardize your safety by increasing your risk of having an accident.
It’s important to ensure that you’re getting enough sleep on your time off and following a healthy lifestyle, to help offset the health risks associated with shift work. If you're feeling low or stressed out, it may be helpful to see a mental healthcare provider, to help you cope.
10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Wickwire EM, Geiger-Brown J, Scharf SM, Drake CL. Shift work and shift work sleep disorder: clinical and organizational perspectives. Chest. 2017;151(5):1156-1172. doi:10.1016/j.chest.2016.12.007
D'Ettorre G, Pellicani V, Caroli A, Greco M. Shift work sleep disorder and job stress in shift nurses: implications for preventive interventions. Med Lav. 2020;111(3):195-202. doi:10.23749/mdl.v111i3.9197
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(Video) What are night shift people supposed to do with sleep?Washington University Physicians. Shift work sleep disorder.
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FAQs
What is shift work sleep disorder? ›
Shift work sleep disorder (SWSD) is a sleep disorder that commonly affects those who work non-traditional hours, outside the typical 9 a.m. to 5 p.m. work day. Shift work schedules go against most peoples' internal body clocks or circadian rhythms.
What is shift work sleep disorder icd10? ›ICD-10 code G47. 26 for Circadian rhythm sleep disorder, shift work type is a medical classification as listed by WHO under the range - Diseases of the nervous system .
What are the effects of shift work on sleep and health? ›People who work night shifts are likely to have shorter sleep duration and/or poorer sleep quality than regular day workers. Long-term exposure to night shift work may elevate the risk of breast cancer. There are also findings pointing to an elevated risk of colorectal cancer.
How do shift workers get enough sleep? ›- Try to keep a regular sleep schedule, including on days off.
- If possible, take 48 hours off after a series of shifts.
- Wear sunglasses when leaving work to minimize sun exposure. ...
- Take naps when possible.
- Limit caffeine intake four hours before bedtime.
For diagnosing shift work disorder, you may be asked to undergo your sleep study during the day instead. While you sleep, an EEG will monitor your vital signs and behaviors during non-rapid eye movement and rapid eye movement stages.
How does shift work and stress affect sleep? ›Shift work can lead to a condition known as shift work sleep disorder (SWSD) – a circadian rhythm sleep disorder that affects people who work non-traditional hours e.g. different shifts or work at night. The main challenge of shift work is that it forces you to sleep against the clock.
Is shift work sleep disorder permanent? ›There's some hope for folks ready to give up the struggle with the overnight shift: insomnia and other sleep problems often associated with those difficult hours may be difficult to shake when it's over, but it's not permanent.
Is shift work sleep disorder in the DSM 5? ›There are criteria of SWSD in the International Classification of Diseases (ICD-10), in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and in the International Classification of Sleep Disorders (ICSD) – Second and Third Editions.
Is shift work a circadian rhythm sleep disorder? ›What Is Shift Work Disorder? Shift work disorder is categorized as a circadian rhythm sleep disorder. This class of medical conditions is characterized by a misalignment between the body and the circadian rhythms that regulate the sleep-wake cycle.
What are the two major symptoms of shift work disorder? ›The average person with shift work disorder loses one to four hours of sleep per night. Excessive sleepiness: Shift work disorder may cause fatigue and reduced alertness while the person is at work during the night or early morning hours. They often feel the need to nap at least once during their shift.
What is the treatment for shift work disorder? ›
- Bright light therapy. Bright light therapy involves exposure to a specific type of light to help your body adjust to your new schedule. ...
- Sleep medications. Your doctor can prescribe a sleeping pill to help you sleep at appropriate times. ...
- Melatonin.
Shift work is linked to poorer working memory and slower mental processing speed, according to Austrian researchers, who warned it may heighten the risk of workplace injuries and errors.
What is the best sleep aid for shift workers? ›Stimulant medications such as Nuvigil and Provigil can relieve sleepiness when people need to be awake. These drugs are approved for the treatment of excessive sleepiness related to shift work disorder, among other conditions. Sleep aids such as Ambien, Lunesta, and Sonata may be prescribed to help with falling asleep.
What medication is used for shift work sleep disorder? ›Wakefulness-Promoting Medications
The Food and Drugs Administration (FDA) has approved two wakefulness-promoting agents for treating shift work disorder, modafinil. See Full Reference and armodafinil. See Full Reference . Taken one hour before work, these drugs may help boost alertness during your shift.
- Cluster night shifts together. ...
- Stick to a routine. ...
- Get your household on board. ...
- Practice good sleep hygiene. ...
- Prioritize sleep. ...
- Eat healthy. ...
- Stay hydrated. ...
- Nap effectively.
Polysomnography, also called a sleep study, is a comprehensive test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements during the study.
How long does it take to recover from years of shift work? ›Summary: Long term shift work is linked to impaired brain power, finds research. The impact (for rotating shift patterns, at least) was stronger after a period of 10 or more years of exposure. And although the effects can be reversed, recovery may take at least five years, the findings suggest.
How long does it take to recover from shift work? ›Our findings indicate that two days off are not sufficient for full recovery, and thus, at least three rest days, one sleeping day (12 hours) and two full days off-duty (48 hours), are needed.
What is the negative impact of shift work? ›Findings: Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work.
What are the consequences of shift work? ›"Researchers have found that shift work is linked to an increased risk of heart attacks, ulcers, depression, obesity and high blood pressure, along with sleep problems, such as trouble falling asleep, trouble staying asleep and excessive sleepiness," he said.
How do you recover from shift work sleep disorder? ›
- Try to keep a regular sleep schedule, including on days off.
- If possible, take 48 hours off after a series of shifts.
- Wear sunglasses when leaving work to minimize sun exposure. ...
- Take naps when possible.
- Limit caffeine intake four hours before bedtime.
Since such symptoms as excessive sleepiness and insomnia are considered medical problems, workers with shift work disorder have a valid reason to claim workers' compensation benefits.
Is a sleep disorder a disability? ›If someone is diagnosed with a sleep disorder that affects their ability to work, they may be eligible for disability benefits if their condition cannot be effectively treated. Complaints about being tired or fatigued would not be enough to qualify for disability benefits.
What are the DSM-5 criteria for sleep disorders? ›Insomnia DSM-5 Criteria
difficulty initiating sleep. In children, this may manifest as difficulty initiating sleep without caregiver intervention. difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakening. Early-morning awakening with inability to return to sleep.
A 30 percent rating is awarded when a veteran experiences chronic daytime sleepiness (i.e. hypersomnolence). A 50 percent rating tends to be the most common evaluation assigned as it is consistent with the veteran's use of a CPAP machine.
Is shift work sleep disorder a disability? ›If someone is diagnosed with a sleep disorder that affects their ability to work, they may be eligible for disability benefits if their condition cannot be effectively treated. Complaints about being tired or fatigued would not be enough to qualify for disability benefits.
What is the best medication for shift work sleep disorder? ›Wakefulness-Promoting Medications
The Food and Drugs Administration (FDA) has approved two wakefulness-promoting agents for treating shift work disorder, modafinil. See Full Reference and armodafinil. See Full Reference . Taken one hour before work, these drugs may help boost alertness during your shift.
Drug name | Rating |
---|---|
Generic name: modafinil systemic Brand name: Provigil Drug class: CNS stimulants For consumers: dosage, interactions, side effects For professionals: AHFS DI Monograph, Prescribing Information | |
Expand current row for information about armodafinil armodafinil | 7.3 |
There are two types of sleep apnea: obstructive sleep apnea (more common) and central sleep apnea, both of which can qualify for SSDI or SSI.
What are the psychological effects of shift work? ›Altered sleep patterns caused by shift work have been linked with irritability, depressed mood, anxiety, and nervousness (45, 46). A prospective study of shift workers found that changes in mental health, including symptoms of depression and anxiety, were modulated by sleep after engaging in shift work for 1 year (47).
How many years does shift work take off your life? ›
Shift work is known to decrease potential lifespan by 10 years. As such, those who opt to do shift work in order to increase their wage-earning capacity, often lose the benefit when they retire.
Does melatonin help with shift work sleep disorder? ›Melatonin supplements may help you adapt better to a shift work schedule. Melatonin is a natural hormone produced by the brain's pineal gland and a signal for when your body is supposed to sleep. Research suggests that a small dose is just as effective as higher doses.
How do you deal with shift work disorder? ›Napping before a shift followed by consumption of a caffeinated drink and, if appropriate, scheduled naps at work, may improve ES in patients with SWD. Use of bright light therapy to partially re-entrain the circadian clock should be explored for all night-shift workers-particularly those with SWD.
Can Adderall be used for shift work disorder? ›Conditions treated by Nuvigil and Adderall
It is approved by the Food and Drug Administration (FDA) for sleep disorders, such as narcolepsy and shift work disorder.
Night shift work has also been shown to raise the risks of mental health issues such as nervousness, irritability, and anxiety as consequences of stressful working conditions. Loss of quality sleep has been attributed to the prevalence of these ailments. The brain and body rest and recharge while we sleep.